Prospective investigations on the spontaneous healing of intraoperative lesions of the mucosa of the nasal septum

Mucosal lesions of the nasal septum during septal surgery are frequent, but there is scarce information in the literature about their outcome. In 283 operations of the nasal septum, 92 (32.5%) mucosal lesions occurred, 67 of these could be documented and classified 1,3 and 6 months postoperatively. Although there was no therapy in 93% (74 cases) of the one-sided lesions, n o permanent septal perforation was seen. A total of 7% (six cases) were tre ated by suture or lyophilised dura combined with tissue adhesive. On the ot her hand, double-sided and correspondent lesions (12 cases: six without the rapy, four sutures, one lyophilised fascia, one tissue adhesive) showed a p erforation in five cases without any symptoms. This represents 1.7% of all operations of the nasal septum and 7.4% of all recorded mucosal lesions of the nasal septum. Although the number of examinations are still few, it mig ht be justifiable to conclude that one-sided lesions of the nasal septum ne ed no specific therapy. AII bilateral corresponding lesions, even those sma ller than 5 mm,should be treated by one-sided suture in the anterior septum and with tissue adhesive in the posterior septum. The use of cartilage, bo ne or fascia alone is insufficient. Large defects of the mucosa should be t reated by maximal therapy, i.e. covering with lyophilised fascia or dura, u nderlaying of cartilage or bone and using tissue adhesive.